两种飞秒激光LASIK术后泪液功能的变化

目的：评估两种不同的飞秒激光制瓣准分子原位角膜磨镶术（laser in situ keratomileusis,LASIK）术后患者在泪液功能和角膜染色方面的变化。 方法：患者40眼行 FS200飞秒激光制瓣 LASIK 手术,40眼行VisuMax飞秒激光制瓣LASIK手术。观察术前及术后1 wk；1,3 mo的泪膜破裂时间（ tear film eak-up time , TBUT）、基础泪液分泌试验（ SchirmerⅠtest,SⅠt）以及角膜荧光素染色（ fluorescent,FL）检查。多个时间点的比较采用重复测量设计的方差分析或Kruskal-Wallis秩和检验,两组间的比较采用两独立样本t检验或Wilcoxon符号秩和检验。 结果：FS200组术后的TBUT有较VisuMax组更少的趋势,但两组间的各项观察指标均没有统计学意义的差别。术后各时间点两组的TBUT值均低于术前（ F=100.37, P〈0.01；F=112.25,P〈0.01）。两组在术后各时间点SⅠt明显低于术前（F=42.15,P〈0.01；F=37.27,P〈0.01）。术后1 wk时FS200的FL （ Z=4.28, P〈0.01）和VisuMax组（Z=4.83,P〈0.01）均较术前增多,但在1mo时恢复到术前水平。 结论：研究表明两种飞秒激光制瓣 ASIK术后的 TBUT、S玉t以及FL的变化一致,但是VisuMax飞秒制瓣LASIK术后的TBUT有比FS200飞秒制瓣LASIK手术更快恢复的趋势。

Comparison of tear function following laser in situ keratomileusis with two femtosecond laser platforms

AIM： To evaluate changes in tear function and corneal staining in patients who underwent laser in situ keratomileusis （ LASIK ） using two different femtosecond lasers. METHODS：Forty eyes underwent FS200 and 40 eyes underwent VisuMax. The tear film break - up time （TBUT）, Schirmer I test （SⅠt） and fluorescein staining were assessed preoperatively at 1wk; 1 and 3mo postoperatively. The analysis of variance （ ANOVA ） for repeat measurements or Kruskal-Wallis ranks test were used. For the differences between FS200 and VisuMax-operated eyes, a independent-samples t test or Wilcoxon matched-samples rank sum test were used. RESULTS： There were no statistical differences in any clinical outcome measure between the two kinds of lasers （P〈0. 05）, although there was a trend towards slightly reductions for TBUT in FS200-operated eyes. TBUT of the two groups eyes showed the same reductions （F=100. 37, P〈0. 01;F=112. 25, P〈0. 01） when compared preoperative levels to 1wk; 1 and 3mo postoperatively levels. Moreover, there were obvious decreases of the SchirmerⅠtest were observed on any visit after the operation for both groups （F= 42. 15, P〈0. 01; F= 37. 27, P〈0. 01）. Furthermore, corneal staining was significantly increased＆amp;nbsp;at 1wk postoperatively （ FS200 Z=4. 88, P〈0. 01; VisuMax Z=4. 28, P〈0. 01） after LASIK compared to preoperative conditions, and recovered to the level of preoperative at 1mo postoperatively. CONCLUSION：This study shows that changes in TBUT, Schirmer I test and corneal staining are statistically similar in LASIK using FS200 and VisuMax femtosecond lasers for flap creation. However, the VisuMax-operated eyes of TBUT after LASIK have faster recovery than in FS200 eyes.